First magnetic navigation catheter intervention in child

Pulmonary atresia with ventricular septal defect (PA-VSD) means that no pulmonary artery exists and the left and right pulmonary valves are blocked. Newborn children with such a defect can only survive because the body develops extra blood vessels, so-called collaterals, to provide the lungs with some, albeit insufficient, perfusion. In Tobias’ case, moreover, the blood flow in the collaterals was disturbed by stenoses. Due to the reduced oxygen uptake it was difficult for Tobias to walk even short distances.

 

PA-VSD has to be treated surgically. Tobias’ heart failure, however, was so complicated that a planned surgical intervention by an international team had to be called-off. Therefore, the cardiologists, Dr Nikoloaus Haas from the hospital for congenital heart defects and Prof Deniz Kececioglu, director of the clinic of thoracic and cardiovascular surgery of the Rhein-Ruhr University Bochum, Germany, decided to repair and support the collaterals with stents using magnetic navigation. It was worldwide the first time the procedure was undertaken in a child.

 

Magnetic navigation allows the surgeon to catheterize vessels that are difficult to access. Small magnets are integrated in the tip of the catheter’s guiding wire and magnetic fields are created to the right and to the left of the patient. A remote-control navigation system guides the catheter through the body with the surgeon following the catheter on a real-time x-ray image. Thus, even the smallest and meandering vessels in Tobias’ lungs could be accessed, expanded and supported with stents.